Everyone
knows HIV is the cause of AIDS, "except maybe two people",
says Dr Robert Gallo, the American government scientist who 10
years ago skilfully marketed HIV to the world. There is no debate,
he says. "Call 5,000 scientists and ask."

Most doctors,
nurses, health educationists and others on the AIDS front line concur.
They are given to understand by the general scientific community
that even to doubt HIV shows mental and moral deficiency. Scientists,
too, have to be careful not to rock the HIV boat, which carries
jobs, reputations and huge research funds.

Despite this
pressure, a large and growing network of highly-qualified "dissidents"
has become established worldwide over the past two years. They not
only challenge the HIV hypothesis, but have "come out"
publicly about their concerns. More than 450 have put their names
to a letter demanding a reappraisal of the conventional view, arguing
that the HIV hypothesis is at best unproven, at worst discredited.

The group contains
more than 70 PhDs, scores of medical doctors and numerous other
health workers and scientists, along with AIDS patients, activists
and others who have been working for years with those most affected
by the epidemic. Most of the names are American-based, but overall
the list spans 23 countries.

It is the tip
of an iceberg of dissent. The group's newsletter has a mailing list
of more than 2,000. A debate over AIDS causation is breaking out
around the world, reflected in a wave of conferences highlighting
alternative ways of thinking about the disease. The latest of these
takes place in Bologna, Italy, this month.

The challenge
has its origins in theoretical considerations first set out in detail
by Professor Peter Duesberg, an eminent American virologist. But
it has drawn strength from the failure of AIDS researchers, after
10 years' work on HIV, to show how the virus could be doing the
damage attributed to it. Gallo claimed to have shown it made its
victims vulnerable to infections by directly killing cells of their
immune system. It is now known he was wrong.

A further blow
to orthodoxy has been the failure to show any lasting benefit from
expensive but highly toxic and potentially lethal anti-HIV drugs.

A third concern
is that the link between HIV and AIDS is much less close than had
been thought. HIV is not the "death sentence" many were
given to understand. The collapse of doomsday predictions about
HIV's spread (3m UK HIV-positives by 1990, according to a 1985 forecast;
actual 10-year cumulative total to date: 21,000) has become apparent
in most countries with careful testing programmes.

The HIV test
itself is discredited. There has been no reasoned response to scientists
who argue it was never properly validated, and that false positives
are the rule not the exception. A crisis looms, probably the biggest
faced by the modern scientific community.

All the more
reprehensible, then, in a discipline dedicated to openness, that
most doctors and scientists are unfamiliar with the dissidents'
detailed arguments because leading scientific and medical journals
refuse to publish them.

Despite the
issue's importance, journal editors and advisers seem to reason,
like Gallo, that since "everyone" agrees HIV is the cause
of AIDS, anyone seriously proposing otherwise is eccentric and illogical.
Dissidents are dangerous, it is argued, because if people doubt
HIV's role in AIDS, they might not heed warnings about the need
to change sexual habits.

John Maddox,
editor of Nature, the science journal, feels so strongly on the
issue that he has been trying to dissuade this newspaper from reporting
evidence that the virus is probably not the cause of AIDS, and that
AIDS may not be an epidemic putting everyone at risk.

Other publications,
lay and professional, follow a similar line. New Scientist magazine,
under the headline "HIV: beyond reasonable doubt", declared
that despite "a mountain of scientific evidence" showing
that HIV does cause AIDS, "a small number of journalists and
dissident scientists continue to question the link". That "mountain"
of evidence never existed; the HIV consensus is crumbling. Maddox
admits that the failure to find a mechanism for how HIV causes the
disease has been "a profound disappointment to the research
community", and that the only evidence implicating the virus
an epidemiological association between testing HIV-positive and
being diagnosed as having AIDS "necessarily seems circumstantial".

Signatories
of the reappraisal letter are united in wanting a change in direction;
they differ in the extent to which they reject the HIV theory.

Some, like
Dr Charles Thomas, a molecular biologist and former Harvard professor
of biochemistry, say it is complete nonsense. "The HIV-causes-AIDS
dogma represents the grandest and perhaps the most morally destructive
fraud that has ever been perpetrated on the young men and women
of the Western world," he says.

Equally outspoken
is Phillip Johnson, senior professor of law, University of California
at Berkeley, and a former visiting professor at University College
London.

"One does
not need to be a scientific specialist to recognise a botched research
job and a scientific establishment that is distorting the facts
to promote an ideology and maximise its funding," he says.
"That establishment continues to doctor statistics and misrepresent
the situation to keep the public convinced that a major viral pandemic
is under way when the facts are otherwise."

Others, like
Dr Lawrence Bradford, a biology professor in Atchison, Kansas, and
Dr Roger Cunningham, a microbiologist and director of the centre
for immunology at the State University of New York at Buffalo, think
the virus could be one factor among many, but maintain an unbiased
reassessment is urgently needed.

"Unfortunately,"
Cunningham says, "an AIDS 'establishment' seems to have formed
that intends to discourage challenges to the dogma on one side and
often insists on following discredited ideas on the other."

Bradford lists
drug use, multiple infections, exposure to blood products, rectal
exposure to semen, and autoimmune phenomena in which the immune
system becomes so confused that it starts to self-destruct as among
interacting events that may lead up to AIDS.

Many other
signatories hold a similar view. Professor Arthur Gottlieb, head
of microbiology and immunology at Tulane University medical school,
New Orleans, believes HIV can disrupt the immune system, but lists
several co-factors, including malnutrition, as important.

Dr Steven Jonas,
professor of preventive medicine, State University of New York at
Stony Brook, says evidence is now "rapidly accumulating"
that the original theory of HIV as the sole cause of AIDS is not
correct. He thinks it plays a part in most cases, but "by itself
it is not sufficient to cause the disease".

Dr Alfred Hassig,
former professor of immunology at the University of Bern and director
of a Swiss blood transfusion laboratory, says multiple stresses
on the immune system provoke an acute reaction, allowing latent
microbes, including HIV, to proliferate. He believes dietary measures
can reverse this process, and urges that "the sentences of
death now accompanying the medical diagnosis of AIDS should be abolished".

Dr Gordon Stewart,
professor emeritus of public health, Glasgow University, and a former
World Health Organisation AIDS adviser, who links AIDS in Western
countries to behaviours carrying high risks of genital and other
infections, points out that the implication of such alternative
views is that existing efforts to fight AIDS are "very wasteful
of effort and expenditure".

Most of the
signatories, such as Dr Henk Loman, professor of biophysical chemistry
at the Free University in Amsterdam, deplore the neglect of non-HIV
lines of research. "There are many people with AIDS but without
HIV, and a great many people with HIV but without AIDS," says
Loman. "These two facts mean that HIV AIDS is much too simple.
Plausible, alternative, testable causes of impairment of the immune
system which may ultimately lead to AIDS should become part of regular
AIDS research."

Many of the
scientists believe the fight against AIDS was derailed by a flaw
in reasoning over HIV in which "the hypothesis itself got incorporated
in the definition of AIDS," as Dr Kary Mullis, winner of last
year's Nobel prize for chemistry, puts it. When people fall sick
and HIV is present or thought to be present, it is called AIDS;
when HIV is not present, it is called something else.

Mullis, who
invented a genetic test used worldwide by AIDS researchers, says
that "the HIV theory, the way it is being applied, is unfalsifiable
and therefore useless as a medical hypothesis". He believes
AIDS arose through "an enormous level of exposure to human
viruses and bacteria".

Robert Maver,
consulting actuary to healthcare and insurance industries, and former
vice-president and director of research with the giant Mutual Benefit
Life Insurance Co, agrees that incorporating HIV into the definition
of AIDS "has created a high correlation that is tautologically
contrived".

Harry Rubin,
professor of molecular and cell biology, University of California
at Berkeley, declares himself "an HIV agnostic. It is not proven
that AIDS is caused by HIV infection, nor is it proven that it plays
no role whatever in the syndrome."

An Italian
signatory, Dr Fabio Franchi, a specialist in preventive medicine
and infectious diseases in Trieste, declares: "I am not agnostic;
I am well convinced, above all by the arguments of Professor Peter
Duesberg." Duesberg, professor of molecular biology at the
University of California at Berkeley, and a founder of the reappraisal
group, says HIV is harmless, and believes long-term misuse of both
recreational and medical drugs is the prime cause of AIDS.

Equally sure
of HIV's innocence is Dr Bernard Forscher, formerly managing editor
of the Proceedings of the National Academy of Sciences. "The
HIV hypothesis ranks with the 'bad air' theory for malaria and the
'bacterial infection' theory for beriberi and pellagra (caused by
nutritional deficiencies)," he says. "It is a hoax that
became a scam."

Paul Rabinow,
professor of anthropology, University of California at Berkeley,
who interviewed Duesberg after becoming "intrigued by the highly
emotional reactions" to his ideas, found there were no convincing
answers to his questions. "In particular I have pursued the
situation of haemophiliacs and HIV because it was the arena least
charged with moralism. Systematic attempts to be allowed to look
at the data or to find rigorous controlled studies have failed."

Another Berkeley
scientist, Dr Richard Strohman, emeritus professor of molecular
and cell biology, is concerned that "while it becomes increasingly
clear that factors other than HIV must be involved in AIDS, the
major research effort continues to focus on the virus".

Harvey Bialy,
research editor of the New York-based journal BioTechnology, who
has a background in molecular biology and tropical disease study
in West Africa, insists that "AIDS" in Africa can mostly
be attributed to economic decline, decline in health care and development
of drug-resistant infections. "All these things can explain
exactly what is going on, to much greater good for the public health
than saying the diseases are being made worse by HIV," he says.

Michael Ellner,
president of Heal (Health Education AIDS Liaison), based in New
York City, a medical hypnotherapist who has worked with thousands
of people with AIDS-related fears and conditions, says: "I
have seen the constant terror, and programming to get sick and die,
that people at risk for developing AIDS face. I am certain that
the hypothesis that long-term drug use is a primary cause of what
is now called AIDS is far more likely to prove true than the failed
notion that AIDS is caused by a germ."

According to
David Mertz, a philosopher of science at the University of Massachusetts,
Amherst, HIV is an "entity of convenience" that met the
needs of powerful groups: researchers competing for personal and
national prestige after the failure of the United States government's
"war on cancer"; gay civil rights campaigners "who
wanted to remake AIDS as an 'equal opportunity killer'," and
the right wing, "who wanted an agent to concretise the 'wrath
of God' that they fantasised as visited upon gays".

If Mertz is
right, will the illusion ever end?

Professor Hiram
Caton, head of the school of applied ethics at Griffith University,
Brisbane, Australia, believes it will. The orthodox view will collapse,
he says, "because it flunks the practical tests. No vaccine
will be forthcoming. No effective treatment will appear. The hype
will exhaust its credibility.

"Scientists
will then have to come to terms with the awful fact that the AIDS
epidemic was a mirage manufactured by scientists who believed that
integrity could be maintained amidst the diverting influences of
big money, prestige and politics." *